Low Back Pain
Low back pain, aching, sore, burning or stinging may be sharp or blunt. While its location can be determined as a point in some cases, it is scattered and undetectable in some cases. It can be light or heavy and exhibit fluctuations.
Pain may be caused by bone, cartilage, muscle, joint capsule, ligament, disc or vein, and not always the exact cause can be revealed. In some cases, although the underlying cause of the pain has disappeared, pain may persist because the nerve endings that have been stimulated continue to send signals. Stress also plays an important role in the cause of low back pain, making it difficult to identify the source.
Low back pain, regardless of tissue, may cause problems such as leg pain, numbness, warming, and urinary incontinence if the related tissues become pressure on the nerves by changing or expanding and thickening.
What is Acute Low Back Pain?
Pain that has been present for less than 6 weeks. It can start after a specific activity or accident, or it can be completely independent of the activity. 80% of people have a serious back pain attack at least once in their lifetime. Often the pain subsides spontaneously. Almost half will fully recover within 2 weeks. In 6 weeks, 80% of people have low back pain. Once, 30% of people with severe low back pain will experience recurrent attacks/attacks or experience chronic pain.
What is Chronic Low Back Pain?
These are back pains that have been present for more than 3 months. Existing tissue irritation causes pain by stimulating the nerve endings in the environment. Inflammation and swelling that develop with the body’s reaction can also contribute to pain. In general, blood flow and oxygenation to the region have also decreased.
This makes it difficult to dispose of harmful wastes in the area that creates pain. Possible sources of pain should be carefully investigated to determine the appropriate treatment.
Low Back Pain and Activity
It is generally believed that it is necessary to avoid daily activities, spend time lying down. However, it is recommended to remain active to the extent that it is ‘tolerable’, especially in acute pain. Continuation of the activity accelerates blood flow, reduces inflammation and muscle tension.
After simple cardio exercises such as walking, people often state that they feel better. Activities such as lifting weights, competitions and contact sports should be avoided.
Cold or hot applications will be useful in different situations. Hot applications can also increase the relaxation of the muscles. However, the contribution of these practices to long-term recovery has not been fully demonstrated.
Causes of Low Back Pain?
Spinal fractures are most often formed at the junction of the 12th vertebral vertebrae and the 1st lumbar vertebra, the most mobile region of the spine. While it is generally seen in young people due to high energy injuries such as falling from a height, traffic accident, firearm injury, it can be seen even after low energy traumas in elderly people with reduced bone density.
Often only the anterior part of the spine is affected and is called a fracture. Fracture of the middle and posterior parts of the spine is also known as burst fracture and may cause partial or complete paralysis due to the broken parts pressing on the spinal cord. If the load on the spine is higher, fracture-dislocations may occur by affecting the soft tissues that hold the vertebrae together.
In spinal fractures, bone-strengthening can be performed with a corset, plaster, various cementing techniques, or open or closed surgery can be performed.
It occurs when the protective outer part of the disc between the vertebrae ruptures and compresses the nerves as a result of sudden or persistent severe strains in the lumbar region due to heavy lifting, working for a long time or staying in the same position, overweight, prolonged stress, multiple births, etc.
Depending on the location and type of the hernia, low back pain or leg pain may be more prominent. Lack of mobility, shortening the walking distance, difficulty in sitting, incontinence, and impotence can cause.
Stress fracture and lower back
Stress fractures called spondylolysis may develop with recurrent microtraumas due to increased mobility in the lower waist region. While these fractures that do not heal for a long time are generally painful in youth, they may not cause problems in adult life.
Due to these stress fractures, the upper vertebra can displace forward compared to the lower one and cause a lumbar shift called spondylolisthesis. Waist slipping can occur for other reasons besides stress fractures.
Lumbar Narrow canal
The spinal cord passing through the spine carries sensation and strength to the legs. Control urine and stool retention. Conditions such as decreased disc height, thickening of the bones, capsules or ligaments of the intervertebral joints, and sliding of the waist may narrow the diameter of the duct through which the spinal cord passes, causing spinal stenosis, that is, narrow duct.
A typical complaint is the development of loss of strength or sensation or numbness tingling in the legs after walking a certain distance. As leaning forward and sitting increases the canal diameter, complaints may decrease or disappear. But it will repeat after walking a certain distance.
50-60% of spinal infections occur in the lumbar region. Smoking, nutritional disorders, obesity, diabetes, HIV and various cancers increase the risk of spinal infection.
It can develop due to bacteria, viruses, and fungi. Spinal bones, discs, nerve membranes called the dura, and surrounding tissues can be affected.
Spinal infections can also develop after previous spinal surgery. The presence of discharge from the wound in the early or late postoperative period, signs such as redness, tenderness and fever at the wound site may be the precursor of the spine infection.
It may be of bone, soft tissue or nerve origin. It can be good or bad. It may originate primarily from the cells that make up the spine and spinal cord, or it can come from a tumor (breast, prostate, etc.) from different parts of the body, and this is called metastasis.
Depending on its location and type, only the tumor itself may need to be removed extensively, along with intact tissues. Fixing with metallic implants, using cage and cement may also be necessary.
Bone resorption, rheumatic diseases, reflected pain, stress and various metabolic conditions can also be the cause of low back pain.